ADHD & MAM, Part II

Physicians are becoming more dependent on using psychotropic medications in the treatment of Attention Deficit Disorder (ADD) and Hyperactivity Attention Deficit Disorder (ADHD). There are many medications presently out on the market and although the Food & Drug Administration has not approved many for use in children, they continue to be prescribed.

Related Article: ADHD & MAM, Part 1

Physicians use a combination method of treatment to include medication therapy, relaxation techniques as well as weekly/monthly sessions for follow-up.

Once the diagnosis has been established, and the medication prescribed, the child can live a normal life with parental guidance, love, caring and a solid structural base. These children need a lot of structure and do best with recurrent routines.

Some children may only need to take one medication, while others need a combination of the mood altering medications in order to provide them with a sufficient level for day-to-day experiences. Many children with ADD/ADHD need a clear set of boundaries. This is especially important when the child is removed from their home environment to attend a sleep-away camp.

Diagnosis

There are many ways to assist a camper in having a successful summer. I will include some of the challenges in having a camper with the diagnosis of ADD/ADHD, on medications and some ways of assuring that the camper has a successful summer.

Nursing staff and counselors must assure that the camper take the prescribed medications on schedule. Taking medications at erratic times may not provide the adequate levels for the medication to be effective.

Some medications like Ritalin can last from four to eight hours, but can be quite individual and unreliable, while other medications such as Strattera or Concerta have a longer duration. Camp nurses have always had to worry about the uninterrupted continuation of medications during camp.

I have witnessed campers being sent home for acting out. This is very sad for all involved and sends a message of failure to those campers; however, these campers cannot be allowed to stay if they are being disruptive, violent or non-compliant about camp activities/regimens.

Camp nurses’ concerns increase when the medication is about to run out and the pharmacy cannot refill the prescription because they are classified as controlled substances.

In the past, the camp relied on the parent to visit the physician to obtain a new order for the medications, fill the prescription at their local pharmacy and ship the medication overnight to the camp’s health care center/infirmary. This takes great skill, coordination, and continuous parental support to ensure there will be an ample amount of medication left for the camper.

It is every parent’s fear that his or her child may be asked to go home during a camp session for an inability to adapt to the routine.

Two years ago, Dana Godel, founder and director of CampMeds, and former camp nurse, identified a growing need for provision of medication during the camp experience. CampMeds has been able to overcome this particular challenge because they receive all the prescriptions in advance and take responsibility for the medications arriving to camp in a timely manner. They not only arrive on time, but also individually sealed in packets for easier dispensation.

Of 8,690 prescriptions servicing 65 camps for the months of June and July 2004, 19% (1,651) were prescriptions written for medications prescribed for ADD/ADHD. Of the 1,651 prescriptions, the following are the percentage breakdown of meds ordered for ADD/ADHD: Concerta-45%, Adderall-26%, Straterra-19%, Ritalin-7%, and Vitamins/supplements-3%.

Many times I have seen the parents leave the decision of taking the medication up to the camper. When this is requested by the parent, it is very important for the medical staff to inquire about what telltale signs are red flags for that child.

This allowance is usually given to older campers who know themselves and can determine when they have reached their limit. They must posses the ability to approach the nurse and request the medication.

However, for those younger in age, a camp nurse usually has to track down the campers that do not readily go to the nurses for medication administration. These children can become disruptive and even at times abusive if they do not receive their medications in a timely manner.

Boundaries

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  1. ADHD & MAM, Part 1
  2. CampDoc Offers Pre-Packaged Medication
  3. ADHD At Camp
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  5. Incremental Improvement, Part 2
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